In the light of the current patient-centred approach to healthcare delivery, this research investigated the effectiveness and safety of paediatric complementary and alternative medicines (CAMs) from the users' perspective in order to generate suitable data to inform healthcare policy and planning. The research was in three parts: a systematic review (SR), a database analysis and a survey. The SR of papers published on the topic from 2000 to July 2011 identified 46 eligible studies conducted predominantly in the USA (14; 30%); with only 5 UK studies (11%), of which 2 were Scottish. Generally, their findings indicated a high report of positive health outcomes by CAM users, and a low report of adverse outcomes. Critical appraisal, however, highlighted the low methodological quality of most studies; with an overall quality rating of 45%, and only 9 studies (20%) possessing up to 8 of 12 quality indices. A tendency towards selective outcome reporting bias was also observed. The database research explored the suspected adverse reactions (ADRs) associated with paediatric use of natural health products (NHPs) as reported on the Yellow Card Scheme (YCS) from its inception until July 2012. The YCS data was mined to estimate the frequency and seriousness of the ADRs reported. NHPs were found to have contributed < 1% of ADR reports within the period, with paediatric subjects contributing 8.6% of NHP reports (192 reports). These profiled 332 specific ADRs, 30% of which were described as serious. Female subjects contributed marginally more ADRs than males (51.5%). Rash and other skin and subcutaneous disorders were the most common ADRs. Herb-drug combination products were found to generate the most ADRs, with the senna-piperazine combination being the most frequently reported (89 ADRs). The product most associated with fatalities was soybean oil (5 reports). Generally, however, NHP-related ADRs reported for paediatric subjects in the YCS were found to be relatively few, and of low severity (6%) and fatality (2%); with over 75% resolution, and mostly within 3 days (68%). The survey component of the research was a bi-modal analytic cross-sectional survey of parents in Aberdeen, and aimed to determine the nature and demography of the use and user-reported outcomes of CAM among children in Aberdeen. Consenting parents recruited from the general population were invited to complete online or paper versions of a validated questionnaire. 212 parents of 391 children completed the survey, of which 143 reported CAM use in their children (67.5%). Participants were mainly mothers (73.6%); Caucasian (84.4%); aged 30-44 years (59.7%); and educated beyond secondary level (85.3%). 213 children had ever used CAM, 64.3% of which had always used CAM; while 21.1% had only used CAM within the last 12 months, and 14.6% had used it only previously. 53.1% of child CAM users were female. Parental self CAM use was found to be the strongest predictor of paediatric CAM use. 102 of the 123 parents that rated their children's CAM use (82.9%) perceived them as helpful; 76 of which said they helped 'a lot'. Finding personal CAM use helpful was the only factor found to significantly predict perceived effectiveness for paediatric CAM use. 9 parents reported adverse outcomes, mainly allergic skin reactions. In all, this research featured the first SR of user-perceived effectiveness and safety outcomes of paediatric CAMs; the first analysis of NHP-associated ADR reports on the YCS; and the first population-based Scottish study of paediatric CAM use. A triangulation of the results from these three strands validated the key finding that CAM is used widely among children, with high perceived effectiveness and safety outcomes. The implications of this finding for healthcare policy and planning were highlighted.

Thesis (Ph.D.) -- University of Western Sydney, 2004. / "A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy" Bibliography : leaves [361]-388.

Ground subsidence due to underground coal mining is a complex, narrowly-understood phenomenon. Due to the complicated physical processes involved and the lack of a complete knowledge of the characteristics of overlying strata, the reliability of current prediction techniques varies widely. Furthermore, the accuracy of any given prediction technique is largely dependent upon the accuracy of field measurements and surveys which provide input data for the technique. A valuable resource available for predicting and modeling subsidence is aerial survey technology. This technology produces yearly datasets with a high density of survey points. The following study introduces a method wherein these survey points are converted into elevation plots and subsidence plots using GIS. This study also presents a method, titled the Type-Xi Integration method (TXI method), which improves upon a previous subsidence prediction technique. This method differs from the previous technique in that it incorporates accurate surface topography and considers irregular mine geometry, as well as seam thickness and overburden variations in its predictions. The TXI method also involves comparing predicted subsidence directly to measured subsidence from subsidence plots. In summary, this study illustrates a method of combining data from aerial survey points and mine geometry with subsidence models in order to improve the accuracy of the models.

No description available.

This thesis borrows the analytical framework of Qallunology to examine a nineteenth-century Arctic whaling encounter between Scottish whalers and an Inuk geographer: Inulluapik. This thesis analyzes the narrative, written by Scottish surgeon Alexander M’Donald, of Inulluapik’s transatlantic journey to Aberdeen, Scotland and Tinnujivik (Cumberland Sound) from 1839 to 1840. I show how Inulluapik’s experience in Aberdeen in 1839, as recorded by M’Donald, provides insight into early Victorian worldviews and perceptions, which I call M’Donald’s Qallunaat-dom and Qallunaat-ness. By conducting a Qallunology of M’Donald’s description of the historical episode, I examine his early Victorian Qallunaat-dom, which compared Inuit from the eastern Arctic to Scots in Aberdeen through his binary understanding of whaling, gender, and spirituality. M’Donald’s interpretation of Inulluapik’s experience demonstrated his contrasting views of Inuit and non-Inuit cultures, which intersected with early Victorian ideas of civilization, intelligence, behaviour, appearance, respectability, female domesticity and marital purity, and Indigenous authenticity. In contrast, Inulluapik demonstrated fluid resistance to M’Donald’s early Victorian binaries of subsistence versus commercial whaling, rural versus urban, primitive versus advanced, and uncivilized versus civilized, and Indigenous versus non-Indigenous. / Graduate

Objetivo: Comparar o tratamento cirúrgico convencional das varizes de membros inferiores com a escleroterapia com espuma ecoguiada nos pacientes com úlcera venosa. Como objetivo secundário, foi comparada a incidência de complicações com os métodos empregados e a melhora na qualidade de vida após a realização dos procedimentos. Casuística e Métodos: Foi realizado um estudo randomizado e prospectivo de 49 pacientes com úlceras ativas (C6), que foram submetidos ao tratamento cirúrgico (28 membros) ou escleroterapia espuma (23 membros), tendo como desfechos a cicatrização de úlceras de origem venosa, complicações do tratamento e qualidade de vida,. Os pacientes completaram o Questionário Aberdeen Veias Varicosas (QAVV), o escore de severidade clínica venoso (ESCV) e o Escore de Incapacidade Venosa (EIV). Resultados: A média e desvio padrão de acompanhamento foi de 502 ± 220 dias. A úlcera cicatrizou em 100% e 91,3% dos doentes tratados com cirurgia ou escleroterapia espuma, respectivamente (P > 0,05). QAVV, ESCV e EIV melhoraram em ambos os grupos após o tratamento. Não houve diferenças significativas no resultado final do QAVV, ESCV e EIV entre os dois grupos, vários meses após os procedimentos (p = 0,45, 0,58 e 0,66, respectivamente; Mann- Whitney U). As complicações ocorreram em 14,2% e 13,0% nos grupos cirúrgico e escleroterapia com espuma, respectivamente. Conclusão: A escleroterapia com espuma não foi inferior ao tratamento cirúrgico de úlceras venosas. Portanto a escleroterapia é uma alternativa ao tratamento cirúrgico, particularmente adequada para pacientes de alto risco cirúrgico que apresentam insuficiência venosa avançada e úlcera ativa / Objective: To compare the results of varicose vein treatment using ultrasoundguided foam sclerotherapy versus conventional surgery in patients with venous ulcers. As a secondary outcome, we compared the incidence of complications related to the employed technique and improvements in quality of life after the procedures. Methods: A randomized and prospective study was conducted in 49 patients with active venous ulcers (C6), submitted to surgical treatment (28 limbs) or foam sclerotherapy (23 limbs). The primary outcomes analysed included healing of venous ulcer, treatment complications and improvements in quality of life. All patients completed the Aberdeen Varicose Veins Questionnaire (AVVQ), the Venous Clinical Severity score (VCSS) and Venous Disability Score (VDS). Results: The mean and standard deviation follow-up was 502 ± 220 days. Ulceration healing was observed in 100% and 91.3% of patients treated with surgery or foam sclerotherapy, respectively (P > 0.05). AVVQ, VCSS and VDS improved in both groups following treatment. There were no significant differences in AVVQ, VCSS and VDS between the two groups several months after the procedures (p = 0,45, 0.58 and 0.66, respectively; Mann-Whitney U test). Complications occurred in 14.2% and 13.0% in the surgical and foam sclerotherapy groups, respectively. Conclusion: Sclerotherapy was non-inferior to surgical treatment in the management of venous ulcers. Therefore sclerotherapy can be considered an alternative to surgical treatment, especially in high surgical risk patients presenting with advanced venous insufficiency and an active ulcer

Objetivo: Comparar o tratamento cirúrgico convencional das varizes de membros inferiores com a escleroterapia com espuma ecoguiada nos pacientes com úlcera venosa. Como objetivo secundário, foi comparada a incidência de complicações com os métodos empregados e a melhora na qualidade de vida após a realização dos procedimentos. Casuística e Métodos: Foi realizado um estudo randomizado e prospectivo de 49 pacientes com úlceras ativas (C6), que foram submetidos ao tratamento cirúrgico (28 membros) ou escleroterapia espuma (23 membros), tendo como desfechos a cicatrização de úlceras de origem venosa, complicações do tratamento e qualidade de vida,. Os pacientes completaram o Questionário Aberdeen Veias Varicosas (QAVV), o escore de severidade clínica venoso (ESCV) e o Escore de Incapacidade Venosa (EIV). Resultados: A média e desvio padrão de acompanhamento foi de 502 ± 220 dias. A úlcera cicatrizou em 100% e 91,3% dos doentes tratados com cirurgia ou escleroterapia espuma, respectivamente (P > 0,05). QAVV, ESCV e EIV melhoraram em ambos os grupos após o tratamento. Não houve diferenças significativas no resultado final do QAVV, ESCV e EIV entre os dois grupos, vários meses após os procedimentos (p = 0,45, 0,58 e 0,66, respectivamente; Mann- Whitney U). As complicações ocorreram em 14,2% e 13,0% nos grupos cirúrgico e escleroterapia com espuma, respectivamente. Conclusão: A escleroterapia com espuma não foi inferior ao tratamento cirúrgico de úlceras venosas. Portanto a escleroterapia é uma alternativa ao tratamento cirúrgico, particularmente adequada para pacientes de alto risco cirúrgico que apresentam insuficiência venosa avançada e úlcera ativa / Objective: To compare the results of varicose vein treatment using ultrasoundguided foam sclerotherapy versus conventional surgery in patients with venous ulcers. As a secondary outcome, we compared the incidence of complications related to the employed technique and improvements in quality of life after the procedures. Methods: A randomized and prospective study was conducted in 49 patients with active venous ulcers (C6), submitted to surgical treatment (28 limbs) or foam sclerotherapy (23 limbs). The primary outcomes analysed included healing of venous ulcer, treatment complications and improvements in quality of life. All patients completed the Aberdeen Varicose Veins Questionnaire (AVVQ), the Venous Clinical Severity score (VCSS) and Venous Disability Score (VDS). Results: The mean and standard deviation follow-up was 502 ± 220 days. Ulceration healing was observed in 100% and 91.3% of patients treated with surgery or foam sclerotherapy, respectively (P > 0.05). AVVQ, VCSS and VDS improved in both groups following treatment. There were no significant differences in AVVQ, VCSS and VDS between the two groups several months after the procedures (p = 0,45, 0.58 and 0.66, respectively; Mann-Whitney U test). Complications occurred in 14.2% and 13.0% in the surgical and foam sclerotherapy groups, respectively. Conclusion: Sclerotherapy was non-inferior to surgical treatment in the management of venous ulcers. Therefore sclerotherapy can be considered an alternative to surgical treatment, especially in high surgical risk patients presenting with advanced venous insufficiency and an active ulcer